Clinical Study On Adenovirus Respiratory Tract Infection In Children In Suzhou

Part one Study on mixed infection of respiratory tract adenovirus in hospitalized children in SuzhouObjective: To investigate the mixed infection of children with adenovirus infection and to compare the clinical characteristics between the mixed group and the non-mixed group.Methods: The clinical data of 392 children with adenovirus infection were collected from January 2011 to December 2015 at the Affiliated Children’s Hospital of Soochow University.The pathogens of mixed were analyzed and the clinical data of simple ADV infection and ADV mixed infection were compared.Results: 1.Among the 392 cases of ADV infection,242 cases(61.7%)were coinfect with other pathogens,among which 43.1%,15.8%,2.6% and 0.2% were included in 1,2,3 and 4 pathogens respectively.2.Mixed infection was found in 144 cases(36.7%)of mycoplasma pneumoniae,135 cases(34.4%)of bacteria and 34 cases(8.7%)of the virus.Check out the virus to HBo V mixed infection most common,bacteria to Streptococcus pneumoniae and Haemophilus influenzae mainly.3.ADV mixed infection can occur in children of all ages,children aged 3-5 years accounted for the highest proportion(28.9%),adenovirus mixed bacterial infections occur in children under 3 years of age.4.In the clinical diagnosis,the upper respiratory tract infection is more common in the simple infection,and lobular pneumonia occurred in the mixed infection group.5.Compared with the non-mixed infection group,the duration of fever and the duration of hospitalization were longer in the mixed infection group.Cough,wheezing,fever ≥7 days and ≥39 ?C occurred in the mixed infection group,while febrile seizures were in the simple infection.The LDH and the incidence of increased creatine kinase isoenzyme in children with mixed infection were higher than those in non-mixed infected patients and the ratio of bronchoscopy was higher.And children of mixed infection group need more gamma globulin and glucocorticoid.Conclusion: 1.More than half of hospitalized adenovirus infection children are mixed with other pathogens,mycoplasma pneumoniae is the most common.2.Adenovirus mixed infection can affect the clinical course of children.Part two Clinical analysis of severe adenovirus pneumoniaObjectives: To analyze the clinical,laboratory and radiological characteristics of children with severe adenovirus pneumonia and to compare the clinical differences between children with respiratory failure and children without respiratory failure.Methods: From January 2011 to December 2015,60 children with severe adenovirus pneumonia were diagnosed by the Affiliated Children’s Hospital of Soochow University,patients were divided into respiratory failure group and non-respiratory failure group according to the children with or without respiratory failure,and 135 children with mild adenovirus pneumonia enrolled in the same period were as the control group.Collect and analyze all the clinical features,laboratory tests,imaging data and the treatment of children.Results: 1.60 cases of severe adenovirus pneumonia in children,49 cases are under 2 years old(81.7%),of which children under 6 months have a higher incidence of respiratory failure(P <0.05).2.All children have fever performance,thermal peak in 39.1 ~ 42.0 ℃ in 57 cases(95%),the median duration of fever was 9(6-13)days,the duration of fever and thermal peak in the respiratory failure group and the non-respiratory failure group were significantly longer than those in the control group(P <0.05).3.Comparison between the three groups,respiratory failure group had longer mechanical ventilation time,oxygen inhalation time,hospitalized and received ICU time,and had a higher incidence of congenital heart disease and other basic diseases,extra-pulmonary complications,ALT> 2 times normal,the decline of hemoglobin in the course of the disease(P <0.05).4.There were 33 cases of pulmonary consolidation in children with severe adenovirus pneumonia(55.9%),mainly to bilateral and the left lower lung.The incidence of pulmonary consolidation in the respiratory failure group and the non-respiratory failure group were significantly higher than those in the control group.Lesions involving 3 and more than 3 lung lobes is more common in children with respiratory failure(P <0.05).Conclusion: 1.Severe adenovirus pneumonia occurs in infants younger than 2 years old,children under 6 months of age have a more severe condition.Children who progressed to respiratory failure are often accompanied with underlying diseases.2.The fever peak is high and the duration of fever is long,and it is often accompanied by pulmonary and extra-pulmonary organ damage.